[Systemic inflammatory response syndrome in critical patients - an analysis of 1,292 cases]

C Ren, X Liu, Z Guo, Q Gao, G Qian, S Yang, H Lu, B Mao
Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine] 1999, 38 (1): 40-3

OBJECTIVE: To study the significance of the occurrence and the development of systemic inflammatory response syndrome (SIRS) in critical patients.

METHODS: The clinical data of 1292 patients accepted by our hospital in ten months from October 1995 to July 1996 were analyzed. The patients met at least two of the criteria for SIRS such as fever, hypothermia, tachycardia, tachypnea or abnormal white blood cell count.

RESULTS: 1292 (67.7%) of the 1909 patients investigated met two or more of the criteria for SIRS. In the 1292 cases, those who met two, three or four of the criteria were respectively 467 (36.1%), 526 (40.7%) and 299 (23.1%). 149 patients (11.5%) in the 1292 cases died of multiple organ dysfunction syndrome (MODS). In which 33 (7.1%), 57 (10.8%) and 59 (19.7%) respectively in patients with two, three and four of the criteria for SIRS. The proportion of patients suffering from acute respiratory distress syndrome, metabolic function dysfunction, disseminated intravascular coagulation and acute renal failure increased with the increase in the number of SIRS criteria that the patients met and with the increase in the proportion of patients progressing from SIRS to septic shock. The mortality rate of the patients also gradually increased while the patients with SIRS were developing sepsis, severe sepsis and septic shock, but there was no statistical significance (P > 0.05).

CONCLUSION: It is suggested that bacterial infection, severe trauma and acute pancreatitis might cause SIRS and compensatory anti-inflammatory response syndrome might play an important role in the maintenance of internal environment of the body. A comprehensive understanding of SIRS might be of help to the management of critical diseases.


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